A SERVICE
OF

Rapamune (sirolimus/rapamycin), a new medication for preventing organ
rejection, has significantly improved graft survival in two phase III clinical
trials, the results of which were presented at the recent 17th World Congress
of the Transplantation Society.

For the first time since the introduction of cyclosporine, the findings
"have clearly demonstrated" the ability of a new drug to improve the
longevity of grafts, said Barry D. Kahan, MD, PhD, of the University of
Texas-Houston Health Science Center, who led the United States-based trial.

In the U.S. study, 719 recipients of kidney transplants at more than 40
centers received cyclosporine and prednisone along with either 5 mg of
Rapamune daily, 2 mg of Rapamune, or azathioprine. Acute rejection
episodes occurred in 10%, 15%, and 24% of patients, respectively.

Similar results occurred with the 576 patients who participated in the
global study, which was conducted in Australia, the United States, Canada, and
six European countries. In this study, the efficacy of 5 mg and 2 mg
of Rapamune was compared to the effects of placebo, and all patients received
cyclosporine and prednisone. Acute rejection occurred in 11% of patients who
received 5 mg of Rapamune, 19% who received 2 mg of Rapamune, and 29%
of patients treated with placebo.

"For transplant physicians and patients alike, these findings hold
promise for an entirely new therapeutic approach," said lead investigator
Allan S. MacDonald, MD, of Dalhousie University in Halifax, Nova Scotia.
"The incidence of rejection in these two studies is the lowest ever
reported in large-scale clinical trials."

Dr. MacDonald added that Rapamune holds promise for "modifying
immunosuppressive therapies so they are significantly less toxic and result in
greater graft survival."

A number of other findings presented at the congress, which was attended by
about 4,000 medical professionals from 79 countries, attracted the attention of
the press:

University of Pittsburgh researchers reported several studies in which
they used altered dendritic cells in animal models to improve the acceptance of
transplanted organs. The research indicates that "donor dendritic cells
genetically modified to protect themselves are less likely to disappear quickly
within a donor body before they have a chance to teach T cells to tolerate a
new organ," said Angus Thomson, PhD, director of transplant immunology at
the University of Pittsburgh.

Investigators at the University of Alberta and the University of Oslo
said that studies are underway in humans to determine the ability of new
genetically engineered compounds to induce immune system tolerance while
protecting patients from viruses and bacteria. Use of such proteins also could
reduce the side effects associated with immunosuppressive drugs.

Among recipients of liver transplants, those who have recurrent
hepatitis C have the lowest quality of life and lowest level of physical
functioning. While quality of life decreased 6% a year after transplantation in
patients who developed hepatitis C, quality of life increased 16% in all other
liver recipients, according to investigators at the VA Medical Center in
Pittsburgh.

Patients have had to wait longer for donor livers in recent years, but
survival rates also have improved, according to researchers at Massachusetts
General Hospital in Boston. The waiting time averaged 122 and 241 days in a two
groups of 72 patients each who underwent liver transplants in 1991 through 1993
and in 1994 through 1996, respectively. However, one-year survival was 68% in
the first group and 89% in the second group.

A questionnaire distributed to 2,500 kidney recipients at 56 transplant
programs in the United States showed that patient compliance is strongly
related to the patient's age, beliefs about the importance of immunosuppressive
drugs, and factors such as the amount of time since the transplant.
Investigators at Montefiore Medical Center in the Bronx defined noncompliance
as missing at least one dose of immunosuppressives in the four weeks before the
study.

Another questionnaire, given to 96 high school students, demonstrated a
lack of awareness among teenagers of the need for minorities to donate more
organs. A total of 69% of white adolescents and 38% of nonwhites knew that
African Americans wait longer for kidney transplants than whites. "It's
interesting to note that the group most affected by the problem was less likely
to believe there was a problem," Reuters news service said in a quote
attributed to researcher Michele Pineda of the University of Washington in
Seattle.